血管内治疗颅内床突旁段动脉瘤

Endovascular treatment of paraclinoid segment aneurysms

目的总结血管内治疗颅内床突旁段动脉瘤的临床经验,通过术后随访其疗效,探讨血管内治疗颅内床突旁段动脉瘤的安全性及有效性。方法我科行血管内治疗的28例颅内床突旁段动脉瘤,通过统计学方法,回顾性分析其临床特点及血管内介入治疗的安全性及效果。结果 28例患者共计28枚动脉瘤:5枚行动脉瘤囊内弹簧圈栓塞;23枚行支架辅助弹簧圈栓塞动脉瘤;血管内介入治疗结束时,血管造影显示,动脉瘤未见显影,支架位置准确无移位,支架内血流通畅,通过门诊、电话、随访3个月至24个月,28例患者Ran-kim评分0～4分。结论血管内治疗颅内床突旁段动脉瘤是安全有效的治疗方法。由于高血分流率的存在,大部分动脉瘤需要支架辅助弹簧圈。

Objective To evaluate the safety and efficacy of interventionl treatment of paraclinoid segment aneurysms as well as the primary indications for such treatment.Methods We conducted a prospective study of 28 patients with 28 aneurysms of the paraclinoid segment in endovascular treatment was attempted.Anatomic results were measured by statistical analysis of variance for such factors as age,sex,clinical presentation,anatomic type（ophthalmic or superior loypophyseal）,size of aneurysms,and width of aneurysm neck,clinical evaluation and control angiography were performed at 3 and 24 months.Results The number of aneurysms is 28 in 28 patients： 5 were treated by direct selective coiling without adjunctive techniques,and 23 aneurysms were treated by stent assisted coiling.Aneurysm were not seen enhancing,stents were scheduled at ideal locations,in-stent patency of blood flow,no shifting.Conclusions The results of this study indicate that endovascular treatment is a safe and effective treatment.But most of the aneurysm need stent-assisted coiling because of the high recurrenc rate.